Israel to investigate Ethiopian birth-control claims

Women were allegedly pressured to use Depo-Provera without proper advice in an attempt to keep community's birth rate low.

An Israeli of Ethiopian origin walks with her child in Netanya, Israel. Israel's health ministry has said it is looking into allegations that Ethiopian Jewish women were pressured to use a controversial contraceptive to curb the community's growth rate.
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BNEI BRAK, ISRAEL // Israel is to investigate reports that Ethiopian women immigrants were coerced or misled into using a long-acting and controversial contraceptives as part of an official policy to curb the community's growth.

Yaakov Litzman, the deputy health minister, is forming a committee of ministry officials and a physician to examine allegations that the powerful birth-control drug Depo-Provera, which can increase the risk of osteoporosis, may have been misused.

The investigation follows demands by Israel's first parliamentarian of Ethiopian descent, Penina Tamanu-Shata, that Mr Litzman "not abet a cover-up of the issue and have it quickly examined by an investigative committee", Israel's Haaretz newspaper reported on Thursday.

An Israeli report in December broadcast allegations of women at Israeli-linked immigration facilities in Ethiopia being forced eight years ago to take Depo-Provera injections, administered every three months. Authorities threatened to block their entry to Israel if they refused, according to the report by Israel's Educational Television, which interviewed 35 women.

Israeli activists have noted an abnormal drop in births among Ethiopian Jews that began more than five years ago, which they have also linked to Depo-Provera prescriptions made by health maintenance organisations (HMO) in Israel.

They point to a 2010 report by the Haifa-based women's organisation Isha L'Isha. It found that about 57 per cent of Depo-Provera users in Israel were Ethiopian Jews despite their community of 120,000 forming less than 2 per cent of Israel's total population of 7.7 million.

The report said the women were neither told about alternatives to the drug nor warned about its side effects, such as a loss in bone density that could lead to osteoporosis. Some Ethiopian Jews have expressed frustration that officials took so long to investigate the claims.

Facing relatively high poverty and rates of domestic violence, they face discrimination in hiring, school enrolment and access to housing that, they say, has worsened with an influx of thousands of illegal African migrants and asylum seekers.

"If this was happening to Russian women or other white women in general, well, first of all it wouldn't have happened," said Efrat Yerday, 31, an Israeli-Ethiopian activist.

"But if it did, there would have been a huge outcry, both on the international level and national level. These are things you can only do to women who are poor and who can't defend themselves."

Itamar Groggo, the director of public health services at Israel's health ministry, denied a policy of targeting Ethiopian women with Depo-Provera. "We don't have a policy about this and if we had one, we wouldn't use Depo-Provera" because of its potential complications, he said in January.

Also in January, Israel's health ministry director, Roni Gamzu, instructed physicians at HMOs not to renew prescriptions of Depo-Provera if they suspected that the patient did not understand the ramifications of taking the drug.

The order came in response to a letter sent to the ministry earlier in the month by Israeli rights groups that expressed concern the drug may have been used to lower Ethiopian birth rates.

"We stated that it's unclear why and where this practice started," said Karen Kaufman, director of international relations at the Association for Civil Rights in Israel, one of the six groups that sent the letter. "We don't know who was responsible for it, but it does raise concern about a policy to bring down the birth rate in the Ethiopian community."

The issue of Depo-Provera's use among Ethiopians in Israel came to the fore in 2008 after a report on the issue in a Hebrew-language newspaper, Yedioth Ahronoth and the efforts of Rachel Mangoli, a manager of a community centre for Ethiopian children in the city of Bnei Brak. She had had only one new child join her centre over the previous three years.

When the former health minister, Yaacov Ben Yezri, was questioned over the issue by a parliamentarian in 2008, he said Depo-Provera was used by Ethiopian women because "it is very popular in Ethiopia" and that there was a "cultural preference" for the drug.

Yet a 1997 study by the World Health Organisationfound that 73.4 per cent of women in Ethiopia preferred oral contraception.